Main features of the ambulatory blood pressure monitoring in the non-controlled essential hypertension patients

Authors

  • V. V. Syvolap Zapozizhzhia State Medical University,
  • S. P. Zhemanyuk Zapozizhzhia State Medical University,

DOI:

https://doi.org/10.14739/2310-1210.2016.4.79894

Keywords:

essential hypertension, blood pressure, ambulatory blood pressure monitoring, ambulatory arterial stiffness index

Abstract

The problem of blood pressure (BP) effective control in Ukrainians is still relevant. Ambulatory blood pressure monitoring (ABPM) is a modern method of BP investigation. However, only some ABPM parameters, as diurnal systolic BP (SBP) and diastolic BP (DBP), now use as the diagnostic guide according to international recommendations.

Aim. To determine peculiarities of ABPM parameters in treated uncontrolled hypertensive patients.

Materials and methods. We investigated 153 patients with essential hypertension and divided two groups according to the level of 24-h SBP and 24-h DBP. There were 103 patients who have uncontrolled levels of BP in the first group and 50 patients with normotensive individuals in the second group.

Results. We had a significant increase of SBP (21,8%; р=0,001), DBP (21,5%; р=0,001), pulse BP (PBP) (22,8%; р=0,001) and the morning surge in SBP (20,7%; р=0,004) in the first group versus the second group. Furthermore, there was a considerable rise in such parameters, like the square of hypertension of diurnal SBP in 9,2 times (р=0,001), daily in 9,5 times (р=0,001), nocturnal in 8,6 times (р=0,001); index of the square of diurnal DBP reduction in 7,2 times (р=0,001), daily in 8,1 times (р=0,001) and nocturnal in 5,7 times (р=0,001) in the first group than in the second group. There was no significant difference in index of night reduce of SBP, speed of morning rise of SBP and DBP, ambulatory arterial stiffness index (AASI) and symmetric slope index (sym_AASI).

Conclusion. This study shows that treated non-controlled hypertensive patients have 20-25% increase in diurnal SBP, DBP and PBP. There is a night-fold increase in diurnal index of SBP square hypertension and a DPB seven-fold increase in diurnal index of square hypertension. There is no statistical significance in index of night reduce of SBP, speed of morning rise of SBP and DBP, AASI and sym_AASI.

References

Dzyak, G. V., Kolesnik, T. V., Pogoreckij, Yu. N. (2005). Sutochnoe monitorirovanie arterial´nogo davleniya [Ambulatory blood pressure monitoring]. Dnepropetrovsk [in Ukrainian].

Pshenicyn, A. I., & Mazur, N. A. (2015) Sutochnoe monitorirovanie arterial´nogo davleniya [Ambulatory blood pressure monitoring]. Moscow: Medpraktika. [in Russian].

Kovalenko, V. M. (ed.) (2016). Sertsevo-sudynni zakhvoriuvannia. Klasyfikatsiia, standarty diahnostyky ta likuvannia [Cardiovascular diseases: Classification, practical protocols of diagnosis and treatment]. Kyiv: Morion [in Ukrainian].

Sirenko, Yu. M. (2011) Gipertonichna khvoroba i arterialna hipertenziia [Essential hypertension and arterial hypertension]. Donetsk: Zaslavskyi [in Ukrainian].

Dolan, E., Li, Y., Thijs, L., McCormack, P., Staessen, J. A., O'Brien, E., & Stanton, A. (2006) Ambulatory arterial stiffness index: rationale and methodology. Blood Press Monit, 11(2), 103–105. doi: 10.1097/01.mbp.0000200478.19046.dd.

Blacher, J., Asmar, R., Djane, S. London, G. M., & Safar, M. E. (1999) Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients. Hypertension, 5, 1111–1117. doi: http://dx.doi.org/10.1161/01.HYP.33.5.1111.

Schillaci, G., Verdecchia, P., Benemio, G., & Porcellati, C. (1995) Blood pressure rice and ischemic stroke. Lancet, 346, 1366–1367.

O’Briend, E., Parati, G., Stergiouc, G., Asmar, R., Beilin, L., Bilo, G. et al. (2013) European society of hypertension position paper on ambulatory blood pressure monitoring J. Hypertens, 9, 1731–1768. doi: 10.1097/HJH.0b013e328363e964.

Parati, G., Stergiouc, G., O’Briend, Е., Asmar, R., Beilin, L., Bilo, G., et al. (2014) European society of hypertension practice guidelines for ambulatory blood pressure monitoring J. Hypertens, 7, 1359–136. doi: 10.1097/HJH.0000000000000221.

Silva, P. M. (2010) Efficacy of fixed-dose combination therapy in the treatment of patients with hypertension: focus on amlodipine/valsartan. Clin. Drug Investig, 30, 625–641. doi: 10.2165/11538440-000000000-00000.

Mancia, G., Fagard, R., Narkiewicz, K., et al. (2013) The Task Force for the management of arterial hypertension of the European Hypertension Society (ESH) and of the European Society of Cardiology (ESC) 2013 ESH / ESC Guidelines for the management of arterial hypertension. J. Hypertens, 31, 1281–1357.

World Health Organization (2014): Ukraine. Retrieved from http://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/ukr.pdf?ua=1.

White, W. B. (1991) Blood pressure load and target organ effects in patients with essential hypertension. J.Hypertens, 9, 39–41.

World Health Organization (2015). WHO Report on the Global Tobacco Epidemic-2015: Country profile Ukraine. Retrieved from http://www.who.int/tobacco/surveillance/policy/country_profile/ukr.pdf?ua=1.

How to Cite

1.
Syvolap VV, Zhemanyuk SP. Main features of the ambulatory blood pressure monitoring in the non-controlled essential hypertension patients. Zaporozhye Medical Journal [Internet]. 2016Oct.13 [cited 2024Nov.23];18(4). Available from: http://zmj.zsmu.edu.ua/article/view/79894

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Section

Original research